Clinical value of NT-ProBNP and BNP in pediatric cardiology

Background: Although less common than in adults, heart disease is a significant cause for morbidity and death in infants and children. Congenital structural cardiac anomalies and acquired heart diseases may result in heart failure. Methods and Results: Available data suggest that the natriuretic peptide system has a similar role in health and disease in the pediatric age group as in adults. In healthy infants and children, levels of B-type natriuretic peptide (BNP) and the N-terminal segment of its pro-hormone (NT-proBNP) are elevated in the first few days after birth. Thereafter, their levels decrease and remain relatively constant throughout childhood. Infants and children with heart disease that causes significant pressure or volume overload of the right or the left ventricle have elevated BNP and NT-proBNP levels. In children with congestive heart failure, BNP and NT-proBNP levels correlate with functional capacity. Both peptides can differentiate cardiac from pulmonary causes in infants with respiratory distress. Limited data suggest that these peptides may also serve as markers in cyanotic, obstructive, and inflammatory heart diseases. Conclusion: The present data suggest that both NT-proBNP and BNP are markers for heart disease in infants and children. Their use may improve clinical practice in pediatric cardiology.